Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

DETRICE GAINES

Kansas City

Summary

Billing Claims Analyst with excellent [Skill] and [Skill] skills. Highly effective at collaborating and working with peers, customers and other stakeholders. Known for efficiency and proactive, goal-oriented planning.

Overview

15
15
years of professional experience
1
1
Certification

Work History

Senior Billing Specialist

Apria Healthcare
11.2016 - Current
  • Responsible for processing CMS -1500 Form claims ,reviewing,tracking, and adjusting Medicaid, Medicaid, and various medical insurance DME claims for accuracy
  • Processing patient correspondence,resubmissions,denials,and copayments past due on behalf of insurance providers
  • Negotiate and reconcile with insurance companies on behalf of clients to assist with billing issues
  • Mail correspondence
  • Research policy and procedures in relation to billing process
  • Maintain quality assurance and prepare claims for resubmission approval
  • Analyzed and generated monthly budget reports
  • Effective meet deadlines with team and upper management
  • Implementing and cross train new employees
  • Managed daily projects and tasks for internal and external Claims departments for deliverables

Credit Card Specialist

GE Capital Retail Bank
05.2013 - 11.2016
  • Leveraged deep knowledge and understanding of the banking industry to handle customer inquiries with increasing complexity.
  • Reviewed and verified vendor completeness and compliance to rectify billing disputes and fraud cases.
  • Monitored existing customer accounts for continued creditworthiness based on analysis of past performance and current information.
  • Maintained product details and protocols to comply with contracts and disclosures.

Documentation Clerk

United Parcel Service, UPS
03.2011 - 05.2013
  • Interviewed software engineers, support staff and quality assurance personnel to understand functionality for documentation needs.
  • Translated complex technical information into intuitive clear format.
  • Created information architecture to format content and method of distribution.
  • Produced on-time communications in support of new product submissions for regulatory agencies.

Education

Associates - Medical Assistance

Heritage College
Kansas City, MO
09.2009

High School Diploma - undefined

Paseo Academy Of Performing Arts
Kansas City, MO
06.2000

Skills

  • Microsoft SharePoint
  • Microsoft Office ( Excel, Word, Powerpoint)
  • Microsoft Power Bi
  • ICD-10/ CPT/HCSPCS Codes
  • Data Analysis
  • Project Management

Certification

Associates Degree in Medical Assistance

Timeline

Senior Billing Specialist

Apria Healthcare
11.2016 - Current

Credit Card Specialist

GE Capital Retail Bank
05.2013 - 11.2016

Documentation Clerk

United Parcel Service, UPS
03.2011 - 05.2013

High School Diploma - undefined

Paseo Academy Of Performing Arts

Associates - Medical Assistance

Heritage College

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